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Sun Y, Tian Y, Cao S, Li L, Yu W, Ding Y, Wang X, Kong Y, Wang X, Wang H, Hui X, Qu J, Wang H, Duan Q, Yang D, Zhang H, Zhou S, Liu X, Li Z, Meng C, Kehlet H, Zhou Y. Multimodal prehabilitation to improve the clinical outcomes of frail elderly patients with gastric cancer: a study protocol for a multicentre randomised controlled trial (GISSG +2201). BMJ Open 2023; 13:e071714. [PMID: 37816552 PMCID: PMC10565164 DOI: 10.1136/bmjopen-2023-071714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/19/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION Gastric cancer (GC) diagnosed in the elderly population has become a serious public health problem worldwide. Given the combined effects of frailty and the consequences of cancer treatment, older individuals with GC are more likely than young patients to suffer from postoperative complications and poor clinical outcomes. Nutrition, functional capacity and psychological state-based multimodal prehabilitation, which is dominated by Enhanced Recovery After Surgery (ERAS) pathway management, has been shown to reduce postoperative complications, promote functional recovery and decrease hospitalisation time in certain malignancies. However, no previous studies have investigated the clinical application of multimodal prehabilitation in frail older patients with GC. METHODS AND ANALYSIS The study is a prospective, multicentre randomised controlled trial in which a total of 368 participants who meet the inclusion criteria will be randomised into either a prehabilitation group or an ERAS group. The prehabilitation group will receive multimodal prehabilitation combined with ERAS at least 2 weeks before the gastrectomy is performed, including physical and respiratory training, nutritional support, and therapy and psychosocial treatment. The ERAS group patients will be treated according to the ERAS pathway. All interventions will be supervised by family members. The primary outcome measures are the incidence and severity of postoperative complications. Secondary outcomes include survival, functional capacity and other short-term postoperative outcomes. Overall, the multimodal prehabilitation protocol may improve functional capacity, reduce the surgical stress response and concomitant systemic inflammation, and potentially modulate the tumour microenvironment to improve short-term and long-term clinical outcomes and patients' quality of life. ETHICS AND DISSEMINATION All procedures and participating centres of this study were approved by their respective ethics committees (QYFYKYLL 916111920). The final study results will be published separately in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05352802.
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Affiliation(s)
- Yuqi Sun
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yulong Tian
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shougen Cao
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan, China
| | - Wenbin Yu
- Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Yinlu Ding
- Department of Gastrointestinal Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Xixun Wang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Ying Kong
- Department of Gastrointestinal Surgery, Jining No.1 People's Hospital, Jining, China
| | - Xinjian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, China
| | - Hao Wang
- Department of General Surgery, Dongying People's Hospital, Dongying, China
| | - Xizeng Hui
- Department of General Surgery, Rizhao People's Hospital, Rizhao, China
| | - Jianjun Qu
- Department of Oncological Surgery, Weifang People's Hospital, Weifang, China
| | - HongBo Wang
- Department of Gastrointestinal Surgery, People's Hospital of Jimo District, Qingdao, People's Republic of China
| | - Quanhong Duan
- Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Daogui Yang
- Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Huanhu Zhang
- Department of Gastrointestinal Surgery, Weihai Municipal Hospital, Weihai, China
| | - Shaofei Zhou
- Department of Gastrointestinal Surgery, Qingdao Municipal Hospital Group, Qingdao, China
| | - Xiaodong Liu
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zequn Li
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cheng Meng
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Henrik Kehlet
- Section of Surgical Pathophysiology, Rigshospitalet Copenhagen University, Denmark, UK
| | - Yanbing Zhou
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Deng X, Shang X, Zhou L, Li X, Guo K, Xu M, Hou L, Hui X, Li S. Efficacy and Safety of Probiotics in Geriatric Patients with Constipation: Systematic Review and Meta-Analysis. J Nutr Health Aging 2023; 27:1140-1146. [PMID: 37997737 DOI: 10.1007/s12603-023-2028-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/01/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Probiotics may be an effective alternative to traditional drug therapy for constipation in the elderly. OBJECTIVE To assess the efficacy and safety of probiotics in managing constipation among the elderly. METHODS Eight databases were queried for randomized controlled trials (RCTs) investigating probiotics' efficacy in addressing constipation among the elderly until January 2023. The meta-analysis was conducted employing R software version 4.2.2. The Cochrane risk of bias tool was utilized to evaluate the risk of bias, and the GRADE approach was employed to assess the credibility of the evidence concerning the efficacy of probiotics in treating constipation in older individuals. RESULTS A total of six RCTs involving 444 patients were included. Two studies were rated as low risk of bias. The meta-analysis findings revealed that probiotics, when compared to a placebo, led to an increase in stool frequency (MD = 1.02,95% CI [0.21, 2.07], p<0.05, very low quality), the probiotic group exhibited a notable impact on ameliorating symptoms associated with constipation (OR = 11.28, 95%CI [7.21, 17.64], p < 0.05, very low quality), no significant disparities were observed in terms of efforts to evacuate, manual maneuvers, and the incidence of adverse events (p>0.05). CONCLUSION The available evidence indicates a degree of uncertainty, ranging from low-to-very low, suggesting the efficacy of probiotics in augmenting bowel frequency and ameliorating constipation-related symptoms among elderly patients with constipation. Nevertheless, given the quality of the studies included, it is advisable to conduct further well-designed investigations with substantial sample sizes to substantiate the findings of this study.
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Affiliation(s)
- X Deng
- Shuangping Li, Gansu Provincial Cancer Hospital, 2 Xiaoxihu East Street, Qilihe District, Lanzhou, China. Emails:
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Tian Y, Cao S, Liu X, Li L, He Q, Jiang L, Wang X, Chu X, Wang H, Xia L, Ding Y, Mao W, Hui X, Shi Y, Zhang H, Niu Z, Li Z, Jiang H, Kehlet H, Zhou Y. Randomized Controlled Trial Comparing the Short-term Outcomes of Enhanced Recovery After Surgery and Conventional Care in Laparoscopic Distal Gastrectomy (GISSG1901). Ann Surg 2022; 275:e15-e21. [PMID: 33856385 PMCID: PMC8683257 DOI: 10.1097/sla.0000000000004908] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to compare the effects of ERAS and conventional programs on short-term outcomes after LDG. SUMMARY OF BACKGROUND DATA Currently, the ERAS program is broadly applied in surgical areas. Although several benefits of LDG with the ERAS program have been covered, high-level evidence is still limited, specifically in advanced gastric cancer. METHODS The present study was designed as a randomized, multicenter, unblinded trial. The enrollment criteria included histologically confirmed cT2-4aN0-3M0 gastric adenocarcinoma. Postoperative complications, mortality, readmission, medical costs, recovery, and laboratory outcomes were compared between the ERAS and conventional groups. RESULTS Between April 2019 and May 2020, 400 consecutive patients who met the enrollment criteria were enrolled. They were randomly allocated to either the ERAS group (n = 200) or the conventional group (n = 200). After excluding patients who did not undergo surgery or gastrectomy, 370 patients were analyzed. The patient demographic characteristics were not different between the 2 groups. The conventional group had a significantly longer allowed day of discharge and postoperative hospital stay (6.96 vs 5.83 days, P < 0.001; 8.85 vs 7.27 days, P < 0.001); a longer time to first flatus, liquid intake and ambulation (3.37 vs 2.52 days, P < 0.001; 3.09 vs 1.13 days, P < 0.001; 2.85 vs 1.38 days, P < 0.001, respectively); and higher medical costs (6826 vs 6328 $, P = 0.027) than the ERAS group. Additionally, patients in the ERAS group were more likely to initiate adjuvant chemotherapy earlier (29 vs 32 days, P = 0.035). There was no significant difference in postoperative complications or in the mortality or readmission rates. Regarding laboratory outcomes, the procalcitonin and C-reactive protein levels on postoperative day 3 were significantly lower and the hemoglobin levels on postoperative day 5 were significantly higher in the ERAS group than in the conventional group. CONCLUSION The ERAS program provides a faster recovery, a shorter postoperative hospitalization length, and lower medical costs after LDG without increasing complication and readmission rates. Moreover, enhanced recovery in the ERAS group enables early initiation of adjuvant chemotherapy.
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Affiliation(s)
- Yulong Tian
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Shougen Cao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaodong Liu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan, China
| | - Qingsi He
- Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Lixin Jiang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Xinjian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, China
| | - Xianqun Chu
- Department of Gastrointestinal Surgery, Jining People's Hospital, Jining, China
| | - Hao Wang
- Department of Gastrointestinal Surgery, Dongying People's Hospital, Dongying, China
| | - Lijian Xia
- Department of Gastrointestinal Surgery, Qianfoshan Hospital of Shandong Province, Jinan, China
| | - Yinlu Ding
- Department of Gastrointestinal Surgery, Second Hospital of Shandong University, Jinan, China
| | - Weizheng Mao
- Department of Gastrointestinal Surgery, Qingdao Municipal Hospital, Qingdao, China
| | - Xizeng Hui
- Department of Gastrointestinal Surgery, Rizhao People's Hospital, Rizhao, China
| | - Yiran Shi
- Department of Oncological Surgery, Weifang People's Hospital, Weifang, China
| | - Huanhu Zhang
- Department of Gastrointestinal Surgery, Weihai Municipal Hospital, Weihai, China
| | - Zhaojian Niu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zequn Li
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haitao Jiang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Henrik Kehlet
- Section of Surgical Pathophysiology 7621, Rigshospitalet Copenhagen University, Copenhagen, Denmark
| | - Yanbing Zhou
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao, China
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Meng C, Cao S, Liu X, Li L, He Q, Xia L, Jiang L, Chu X, Wang X, Wang H, Hui X, Sun Z, Huang S, Duan Q, Yang D, Zhang H, Tian Y, Li Z, Zhou Y. Effect of preoperative CT angiography examination on the clinical outcome of patients with BMI ≥ 25.0 kg/m 2 undergoing laparoscopic gastrectomy: study protocol for a multicentre randomized controlled trial. Trials 2021; 22:912. [PMID: 34895320 PMCID: PMC8666026 DOI: 10.1186/s13063-021-05887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gastric cancer, which is the fifth most common malignancy and the third most common cause of cancer-related death, is particularly predominant in East Asian countries, such as China, Japan and Korea. It is a serious global health issue that causes a heavy financial burden for the government and family. To our knowledge, there are few reports of multicentre randomized controlled trials on the utilization of CT angiography (CTA) for patients who are histologically diagnosed with gastric cancer before surgery. Therefore, we planned this RCT to verify whether the utilization of CTA can change the short- and long-term clinical outcomes. METHOD The GISSG 20-01 study is a multicentre, prospective, open-label clinical study that emphasises the application of CTA for patients who will undergo laparoscopic gastrectomy to prove its clinical findings. A total of 382 patients who meet the inclusion criteria will be recruited for the study and randomly divided into two groups in a 1:1 ratio: the CTA group (n = 191) and the non-CTA group (n = 191). Both groups will undergo upper abdomen enhanced CT, and the CTA group will also receive CT angiography. The primary endpoint of this trial is the volume of blood loss. The second primary endpoints are the number of retrieved lymph nodes, postoperative recovery course, hospitalization costs, length of hospitalization days, postoperative complications, 3-year OS and 3-year DFS. DISCUSSION It is anticipated that the results of this trial will provide high-level evidence and have clinical value for the application of CTA in laparoscopic gastrectomy. TRIAL REGISTRATION ClinicalTrials.gov , NCT04636099. Registered November 19, 2020.
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Affiliation(s)
- Cheng Meng
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Shougen Cao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Xiaodong Liu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan, China
| | - Qingsi He
- Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Lijian Xia
- Department of Gastrointestinal Surgery, Qianfoshan Hospital of Shandong Province, Jinan, China
| | - Lixin Jiang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Xianqun Chu
- Department of Gastrointestinal Surgery, Jining No.1 People's Hospital, Jining, China
| | - Xinjian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, China
| | - Hao Wang
- Department of Gastrointestinal Surgery, Dongying People's Hospital, Dongying, China
| | - Xizeng Hui
- Department of Gastrointestinal Surgery, Rizhao People's Hospital, Rizhao, China
| | - Zuocheng Sun
- Department of Oncological Surgery, Weifang People's Hospital, Weifang, China
| | - Shusheng Huang
- Department of Gastrointestinal Surgery, People's Hospital of Jimo District, Qingdao, China
| | - Quanhong Duan
- Department of Gastrointestinal Surgery, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Daogui Yang
- Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Huanhu Zhang
- Department of Gastrointestinal Surgery, Weihai Municipal Hospital, Weihai, China
| | - Yulong Tian
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Zequn Li
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Yanbing Zhou
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China.
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Seraphim A, Knott K, Menacho K, Augusto J, Davies R, Joy G, Hui X, Treibel T, Cooper J, Petersen S, Fontana M, Hughes A, Moon J, Manisty C, Kellman P. Comparison of the prognostic value of stress and rest pulmonary transit time estimation using myocardial perfusion CMR. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Clinical Research Training Fellowship
Background
Pulmonary transit time (PTT) is a quantitative biomarker of cardiopulmonary status. Rest PTT was previously shown to predict outcomes in specific disease models, but clinical adoption is hindered but challenges in data acquisition. Whether evaluation of PTT during stress encodes incremental prognostic information has not been previously investigated as scale.
Objectives
To compare the prognostic value of stress and rest PTT derived from a fully automated, in-line method of estimation using perfusion CMR, in a large patient cohort.
Methods
A retrospective two-center study of patients referred clinically for adenosine stress myocardial perfusion assessment using CMR. Analysis of right and left ventricular cavity arterial input function curves from first pass perfusion was performed automatically, allowing the in-line estimation of both rest and stress PTT. Association with major adverse cardiovascular events (MACE) was evaluated. MACE was defined as a composite outcome of myocardial infarction, stroke, heart failure admission and ventricular tachycardia or appropriate ICD treatment (including ICD shock and/or anti-tachycardia pacing).
Results
985 patients (67% male, median age 62 years (IQR 52,71)) were included, with median left ventricular ejection fraction (LVEF) of 62% (IQR 54-69). Median stress PTT was shorter than rest PTT 6.2 (IQR 5.1, 7.7) seconds versus 7.7 (IQR, 6.4, 9.2) seconds. Stress and rest PTT were highly correlated (r = 0.69; p < 0.001). Stress PTT also correlated with LVEF (r=-0.37), stress MBF (r=-0.31), LVEDVi (r = 0.24), LA area index (r = 0.32) (p < 0.001 for all). Over a median follow-up period of 28.6 (IQR, 22.6 35,7) months, MACE occurred in 61 (6.2%) patients. After adjusting for prognostic factors, both rest and stress PTT, independently predicted MACE, but not all-cause mortality. For every 1xSD (2.39s) increase in rest PTT the adjusted hazard ratio (HR) for MACE was 1.43 (95% CI 1.10-1.85, p = 0.007). The hazard ratio for one standard deviation (2.64s) increase in stress PTT was 1.34 (95% CI 1.048-1.723; p = 0.020) after adjusting for age, LVEF, hypertension, diabetes, sex and presence of LGE
Conclusions
In this 2-center study of 985 patients, we deploy a fully automated method of PTT estimation using perfusion mapping with CMR and show that both stress and rest PTT are independently associated with adverse cardiovascular outcomes. In this patient cohort, there is no clear incremental prognostic value of stress PTT, over its evaluation during rest.
Figure 1. Stress and Rest Pulmonary Transit Time estimation using myocardial perfusion CMR
Figure 2. Event-free survival curves for major adverse cardiovascular events (Heart failure hospitalization, myocardial infarction, stroke and ventricular tachycardia/ICD treatment) according to mean rest PTT (8.05seconds) and mean stress PTT (6.7seconds). Log-rank for both p < 0.05
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Affiliation(s)
- A Seraphim
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - K Knott
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - K Menacho
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - J Augusto
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - R Davies
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - G Joy
- St Bartholomew"s Hospital, Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - X Hui
- National Institutes of Health, Bethesda, United States of America
| | - T Treibel
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - J Cooper
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Petersen
- Queen Mary University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - M Fontana
- Royal Free Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - A Hughes
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - J Moon
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - C Manisty
- University College London, Institute of Cardiovascular Science, London, United Kingdom of Great Britain & Northern Ireland
| | - P Kellman
- National Institutes of Health, Bethesda, United States of America
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Li S, Lv C, Li J, Xie T, Liu X, Zheng Z, Qin Z, Hui X, Yu Y. LncRNA LINC00473 promoted colorectal cancer cell proliferation and invasion by targeting miR-195 expression. Am J Transl Res 2021; 13:6066-6075. [PMID: 34306345 PMCID: PMC8290708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/14/2019] [Indexed: 06/13/2023]
Abstract
Long noncoding RNAs (lncRNAs) have been shown to play crucial roles in cancer development. However, the role of LINC00473 in colorectal cancer has not been explored. In our study, we showed that LINC00473 expression was upregulated in colorectal cancer samples compared to nontumor samples. The expression of LINC00473 in colorectal cancer tissues from patients with distant metastasis was higher than that from cases without distant metastasis. The higher expression level of LINC00473 was positively correlated with advanced clinical stage. The elevated expression of LINC00473 accelerated colorectal cancer cell proliferation, cell cycle progression and invasion. Moreover, overexpression of LINC00473 induced epithelial to mesenchymal (EMT) progression in HT29 and SW480 cells. Ectopic expression of LINC00473 suppressed miR-195 expression in colorectal cancer cells. miR-195 expression was downregulated in colorectal cancer samples compared with nontumor samples. The expression of miR-195 in colorectal cancer tissues from patients with distant metastasis was lower than that from cases without distant metastasis. The lower expression level of miR-195 was positively correlated with advanced clinical stage. In addition, we showed that the expression of miR-195 was negatively correlated with the LINC00473 expression level in colorectal cancer tissues. LINC00473 accelerated colorectal cancer cell proliferation and cell cycle progression and regulated EMT progression by regulating miR-195 expression. These data suggested that LINC00473 induced cell proliferation, cell cycle progression and EMT progression by acting as a ceRNA for miR-195 in colorectal cancer.
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Affiliation(s)
- Shilei Li
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Chunyu Lv
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Jun Li
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Tao Xie
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Xianbin Liu
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Zhiwei Zheng
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Zhaoyang Qin
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Xizeng Hui
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
| | - Yang Yu
- Department of General Surgery, Rizhao People's Hospital Rizhao 276800, Shandong, China
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Tian Y, Cao S, Li L, He Q, Xia L, Jiang L, Ding Y, Wang X, Wang H, Mao W, Hui X, Shi Y, Zhang H, Chu X, Kehlet H, Zhou Y. Effects of perioperative enhanced recovery after surgery pathway management versus traditional management on the clinical outcomes of laparoscopic-assisted radical resection of distal gastric cancer: study protocol for a randomized controlled trial. Trials 2020; 21:369. [PMID: 32357913 PMCID: PMC7193340 DOI: 10.1186/s13063-020-04272-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/20/2020] [Indexed: 02/08/2023] Open
Abstract
Background The incidence of gastric cancer in East Asia is much higher than the international average. Therefore, improving the prognosis of patients and establishing effective clinical pathways are important topics for the prevention and treatment of gastric cancer. At present, the enhanced recovery after surgery (ERAS) pathway is widely used in the field of gastric surgery. Many randomized controlled trial (RCT) studies have proven that the ERAS regimen can improve the short-term clinical outcomes of patients with gastric cancer. However, a prospective study on the effect of the ERAS pathway on the prognosis of patients with gastric cancer has not yet been reported. This trial aims to confirm whether the ERAS pathway can improve the disease-free survival and overall survival of patients undergoing laparoscopic-assisted radical resection for distal gastric cancer. Methods/design This study is a prospective, multicentre RCT. This experiment will consist of two groups – an experimental group and a control group – randomly divided in a 1:1 ratio. The perioperative period of the experimental group will be managed according to the ERAS pathway and that of the control group will be managed according to the traditional management mode. An estimated 400 patients will be enrolled. The main endpoint for comparison is the 3-year overall survival and disease-free survival between the two groups. Discussion The results of this RCT should clarify whether the ERAS pathway is superior to traditional treatment on inflammatory indexes, short-term clinical outcome and survival for laparoscopic-assisted radical resection of distal gastric cancer. It is hoped that our data will provide evidence that the ERAS pathway improves survival in patients with gastric cancer. Trial registration Chinese Clinical Trial Registry, CHiCTR1900022438. Registered on 11 April 2019.
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Affiliation(s)
- Yulong Tian
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Shougen Cao
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan, China
| | - Qingsi He
- Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Lijian Xia
- Department of Gastrointestinal Surgery, Qianfoshan Hospital of Shandong Province, Jinan, China
| | - Lixin Jiang
- Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai, China
| | - Yinlu Ding
- Department of Gastrointestinal Surgery, Second Hospital of Shandong University, Jinan, China
| | - Xinjian Wang
- Department of Gastrointestinal Surgery, Weihai Central Hospital, Weihai, China
| | - Hao Wang
- Department of Gastrointestinal Surgery, Dongying People's Hospital, Dongying, China
| | - Weizheng Mao
- Department of Gastrointestinal Surgery, Qingdao Municipal Hospital, Qingdao, China
| | - Xizeng Hui
- Department of Gastrointestinal Surgery, Rizhao People's Hospital, Rizhao, China
| | - Yiran Shi
- Department of Oncological Surgery, Weifang People's Hospital, Weifang, China
| | - Huanhu Zhang
- Department of Gastrointestinal Surgery, Weihai Municipal Hospital, Weihai, China
| | - Xianqun Chu
- Department of Gastrointestinal Surgery, Jining People's Hospital, Jining, China
| | - Henrik Kehlet
- Section of Surgical Pathophysiology 4074, Rigshospitalet Copenhagen University, Copenhagen, Denmark
| | - Yanbing Zhou
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, China.
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Zhang X, Ning L, Hu Y, Zhao S, Li Z, Li L, Dai Y, Jiang L, Wang A, Chu X, Li Y, Yang D, Lu C, Yao L, Cui G, Lin H, Chen G, Cui Q, Guo H, Zhang H, Lun Z, Xia L, Su Y, Han G, Hui X, Wei Z, Sun Z, Shen S, Zhou Y. Prognostic Factors for Primary Localized Gastrointestinal Stromal Tumors After Radical Resection: Shandong Gastrointestinal Surgery Study Group, Study 1201. Ann Surg Oncol 2020; 27:2812-2821. [PMID: 32040699 DOI: 10.1245/s10434-020-08244-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Most previous risk-prediction models for gastrointestinal stromal tumors (GISTs) were based on Western populations. In the current study, we collected data from 23 hospitals in Shandong Province, China, and used the data to examine prognostic factors in Chinese patients and establish a new recurrence-free survival (RFS) prediction model. METHODS Records were analyzed for 5285 GIST patients. Independent prognostic factors were identified using Cox models. Receiver operating characteristic curve analysis was used to compare a novel RFS prediction model with current risk-prediction models. RESULTS Overall, 4216 patients met the inclusion criteria and 3363 completed follow-up. One-, 3-, and 5-year RFS was 94.6% (95% confidence interval [CI] 93.8-95.4), 85.9% (95% CI 84.7-87.1), and 78.8% (95% CI 77.0-80.6), respectively. Sex, tumor location, size, mitotic count, and rupture were independent prognostic factors. A new prognostic index (PI) was developed: PI = 0.000 (if female) + 0.270 (if male) + 0.000 (if gastric GIST) + 0.350 (if non-gastric GIST) + 0.000 (if no tumor rupture) + 1.259 (if tumor rupture) + 0.000 (tumor mitotic count < 6 per 50 high-power fields [HPFs]) + 1.442 (tumor mitotic count between 6 and 10 per 50 HPFs) + 2.026 (tumor mitotic count > 10 per 50 HPFs) + 0.096 × tumor size (cm). Model-predicted 1-, 3-, and 5-year RFS was S(12, X) = 0.9926exp(PI), S(36, X) = 0.9739exp(PI) and S(60, X) = 0.9471exp(PI), respectively. CONCLUSIONS Sex, tumor location, size, mitotic count, and rupture were independently prognostic for GIST recurrence. Our RFS prediction model is effective for Chinese GIST patients.
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Affiliation(s)
- Xiaoqian Zhang
- Division of General Surgery, Peking University First Hospital, Peking University, Beijing, China.,Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Liang Ning
- Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yulong Hu
- Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Shanfeng Zhao
- Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zequn Li
- Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Yong Dai
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Lixin Jiang
- Department of Gastrointestinal Thyroid Surgery, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Ailiang Wang
- Department of Gastrointestinal Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Xianqun Chu
- Department of Gastroenterology Surgery, Jining No.1 People's Hospital, Jining, Shandong, China
| | - Yuming Li
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Daogui Yang
- Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, China
| | - Chunlei Lu
- Department of Laparoscopic Surgery Center, Linyi People's Hospital, Linyi, Shandong, China
| | - Linguo Yao
- Department of Gastrointestinal Surgery, Shengli Oilfield Central Hospital, Yantai, Shandong, China
| | - Gang Cui
- Department of General Surgery, Taian City Central Hospital, Taian, Shandong, China
| | - Huizhong Lin
- Department of Gastric Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Gang Chen
- Department of Gastrointestinal Surgery, Tengzhou Central People's Hospital, Tengzhou, Shandong, China
| | - Qing Cui
- Department of General Surgery, Zibo Central Hospital, Zibo, Shandong, China
| | - Hongliang Guo
- The Fourth Department of General Surgery, Shandong Cancer Hospital, Jinan, Shandong, China
| | - Huanhu Zhang
- Department of General Surgery, Weihai Municipal Hospital, Weihai, Shandong, China
| | - Zengjun Lun
- Department of General Surgery, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China
| | - Lijian Xia
- Department of Gastrointestinal Surgery, Shandong Province Qianfoshan Hospital, Jinan, Shandong, China
| | - Yingfeng Su
- Department of General Surgery, Dezhou People's Hospital, Dezhou, Shandong, China
| | - Guoxin Han
- Department of General Surgery, Affiliated Hospital of Taishan Medical University, Taian, Shandong, China
| | - Xizeng Hui
- Department of Surgery, People's Hospital of Rizhao, Rizhao, Shandong, China
| | - Zhixin Wei
- Department of General Surgery, Heze Municipal Hospital, Heze, Shandong, China
| | - Zuocheng Sun
- Department of Surgery, Weifang People's Hospital, Weifang, Shandong, China
| | - Shuai Shen
- Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yanbing Zhou
- Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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Liying M, Yuanyuan Z, Qianqian Y, Ming N, Tingting L, Chen W, Yibo D, Lingjie L, Hui X, Chen C. The dynamics of HIV-1 quasispecies diversity circulating in the plasma RNA and cellular DNA of patients with ART. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Page B, Han P, Peng L, Cheng Z, Harkness J, Shen C, Choflet A, Cecil E, Hui X, Schmitt N, Shpitser I, McNutt T, Quon H. Gender Differences in Radiation Therapy Effects in Male and Female Patients With Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Wang L, Liu Z, Hui X, Xu A, Cheng K. The Role of Hepatic MDM2 in the Regulation of Energy and Lipid Metabolism in Obesity. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.lb389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L. Wang
- Department of MedicineUniversity of Hong KongHong Kong
| | - Z. Liu
- Department of MedicineUniversity of Hong KongHong Kong
| | - X. Hui
- Department of MedicineUniversity of Hong KongHong Kong
| | - A. Xu
- Department of MedicineUniversity of Hong KongHong Kong
- Department of Pharmacology and PharmacyUniversity of Hong KongHong Kong
| | - K.K.Y. Cheng
- Department of Pharmacology and PharmacyUniversity of Hong KongHong Kong
- The Hong Kong PolytechnicHong Kong
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Nakatsugawa M, Cheng Z, Hui X, Choflet A, Kiess A, Bowers M, Utsunomiya K, Sugiyama S, Wong J, McNutt T, Quon H. The Value of Continuous Toxicity Updates on the Accuracy of Prediction Models within a Learning Health System. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Hui X, Cheng Z, Robertson S, Peng L, Bowers M, Moore J, Choflet A, Thompson A, Muse M, Kiess A, Page B, Gourin C, Fakhry C, Szczesniak M, Maclean J, Cook I, McNutt T, Quon H. Validation of a Dysphagia Signature Using Unsupervised Cluster Analysis of the MD Anderson Dysphagia Inventory and the Sydney Swallow Questionnaire Confirms Three Unique Patient Groups. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Peng L, Hui X, Cheng Z, Bowers M, Moore J, Choflet A, Thompson A, Muse M, Kiess A, Page B, Gourin C, Fakhry C, Szczesniak M, Maclean J, Cook I, McNutt T, Quon H. Correlation of Functional Assessment of Cancer Therapy With the MD Anderson Dysphagia Inventory and the Sydney Swallow Questionnaire in a Prospective Cohort of Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Semenov Y, Hsiang E, Huang A, Hui X, Kwatra S, Cohen B, Anadkat M. 016 Psoriatic arthritis and hearing loss. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Hou Q, Luo W, Li L, Dai Y, Jiang L, Wang A, Chu X, Li Y, Yang D, Lu C, Yao L, Cui G, Lin H, Chen G, Cui Q, Zhang H, Lun Z, Xia L, Su Y, Han G, Hui X, Wei Z, Sun Z, Guo H, Zhou Y. [Analysis of gastric gastrointestinal stromal tumors in Shandong Province: a midterm report of multicenter GISSG1201 study]. Zhonghua Wei Chang Wai Ke Za Zhi 2017; 20:1025-1030. [PMID: 28900994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To summarize the treatment status of gastric gastrointestinal stromal tumor (GIST) in Shandong province,by analyzing the clinicopathological features and prognostic factors. METHODS Clinicopathological and follow-up data of 1 165 patients with gastric GIST between January 2000 and December 2013 from 23 tertiary referral hospitals in Shandong Province were collected to establish a database. The risk stratification of all cases was performed according to the National Institutes of Health(NIH) criteria proposed in 2008. Kaplan-Meier method was used to calculate the survival rate. Log-rank test and Cox regression model were used for univariate and multivariate prognostic analyses. RESULTS Among 1 165 cases of gastric GIST, 557 were male and 608 were female. The median age of onset was 60 (range 15-89) years. Primary tumors were located in the gastric fundus and cardia in 623 cases(53.5%), gastric body in 346 cases(29.7%), gastric antrum in 196 cases(16.8%). All the cases underwent resection of tumors, including endoscopic resection (n=106), local resection (n=589), subtotal gastrectomy(n=399), and total gastrectomy(n=72). Based on the NIH risk stratification, there were 256 cases (22.0%) at very low risk, 435 (37.3%) at low risk, 251 cases (21.5%) at intermediate risk, and 223 cases (19.1%) at high risk. A total of 1 116 cases(95.8%) were followed up and the median follow-up period was 40 (range, 1-60) months. During the period, 337 patients relapsed and the median time to recurrence was 34 (range 1-60) months. The 1-, 3-, and 5-year survival rates were 98.6%, 86.1% and 73.4%, respectively. The 5-year survival rates of patients at very low, low, intermediate, and high risk were 93.1%, 85.8%, 63.0% and 42.3% respectively, with a statistically significant difference (P=0.000). Multivariate analysis showed that primary tumor site (RR=0.580, 95%CI:0.402-0.835), tumor size (RR=0.450, 95%CI:0.266-0.760), intraoperative tumor rupture(RR=0.557, 95%CI:0.336-0.924), risk classification (RR=0.309, 95%CI:0.164-0.580) and the use of imatinib after surgery (RR=1.993, 95%CI:1.350-2.922) were independent prognostic factors. CONCLUSIONS The choice of surgical procedure for gastric GIST patients should be based on tumor size. All the routine procedures including endoscopic resection, local excision, subtotal gastrectomy and total gastrectomy can obtain satisfactory curative outcomes. NIH classification has a high value for the prediction of prognosis. Primary tumor site, tumor size, intraoperative tumor rupture, risk stratification and postoperative use of imatinib are independent prognostic factors in gastric GIST patients.
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Affiliation(s)
- Qingsheng Hou
- Surgical Ward 4, Shandong Cancer Hospital Affiliated to Shandong Universit, Jinan 250022, China
| | - Wenqiang Luo
- Department of General Surgery, Affiliated Hospital of Medical College of Qingdao University, Qingdao 266003, China
| | - Leping Li
- Department of General Surgery, Shandong Provincial Hospital, Jinan 250021, China
| | - Yong Dai
- Department of General Surgery, Qilu Hospital of Shandong University,Jinan 250012, China
| | - Lixin Jiang
- Department of General Surgery, Yantai Yuhuangding Hospital, Yantai 264000, China
| | - Ailiang Wang
- Department of General Surgery, Jining Medical College Affiliated Hospital,Jining 272000, China
| | - Xianqun Chu
- Department of General Surgery, Jining People's Hospital, Jining 272011, China
| | - Yuming Li
- Department of General Surgery, Affiliated Hospital of Binzhou Medical College, Binzhou 256600, China
| | - Daogui Yang
- Department of General Surgery, Liaocheng People's Hospital, Liaocheng 252000, China
| | - Chunlei Lu
- Department of General Surgery, Linyi People's Hospital, Linyi 276003, China
| | - Linguo Yao
- Department of General Surgery, Dongying Shengli Oilfield Central Hospital, Dongying 257000, China
| | - Gang Cui
- Department of General Surgery, Tai'an City Central Hospital, Tai'an 271000, China
| | - Huizhong Lin
- Department of General Surgery, Qingdao Municipal Hospital, Qingdao 266011, China
| | - Gang Chen
- Department of General Surgery, Tengzhou People's Hospital, Zhaozhuang 277500, China
| | - Qing Cui
- Department of General Surgery, Zibo City Central Hospital, Zibo 255036, China
| | - Huanhu Zhang
- Department of General Surgery, Weihai Municipal Hospital, Weihai 264200, China
| | - Zengjun Lun
- Department of General Surgery, Zaozhuang City Hospital, Zaozhuang 277100, China
| | - Lijian Xia
- Department of General Surgery, Zaozhuang City Hospital, Zaozhuang 277100, China
| | - Yingfeng Su
- Department of General Surgery, Dezhou People's Hospital, Dezhou 253014, China
| | - Guoxin Han
- Department of General Surgery, Affiliated Hospital of Taishan Medical College, Taian 271000, China
| | - Xizeng Hui
- Department of General Surgery, Rizhao People's Hospital, Rizhao 276800, China
| | - Zhixin Wei
- Department of General Surgery, Heze Municipal Hospital, Heze 274031, China
| | - Zuocheng Sun
- Department of General Surgery, Weifang People's Hospital, Weifang 261000, China
| | - Hongliang Guo
- Surgical Ward 4, Shandong Cancer Hospital Affiliated to Shandong Universit, Jinan 250022, China.
| | - Yanbing Zhou
- Department of General Surgery, Affiliated Hospital of Medical College of Qingdao University, Qingdao 266003, China
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Blair AB, Dwarakanath A, Mehta A, Liang H, Hui X, Wyman C, Ouanes JPP, Nguyen HT. Postoperative urinary retention after inguinal hernia repair: a single institution experience. Hernia 2017; 21:895-900. [PMID: 28871414 DOI: 10.1007/s10029-017-1661-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 08/25/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Inguinal hernia repair is a common general surgery procedure with low morbidity. However, postoperative urinary retention (PUR) occurs in up to 22% of patients, resulting in further extraneous treatments.This single institution series investigates whether patient comorbidities, surgical approaches, and anesthesia methods are associated with developing PUR after inguinal hernia repairs. METHODS This is a single institution retrospective review of inguinal hernia from 2012 to 2015. PUR was defined as patients without a postoperative urinary catheter who subsequently required bladder decompression due to an inability to void. Univariate and multivariate logistic regressions were performed to quantify the associations between patient, surgical, and anesthetic factors with PUR. Stratification analysis was conducted at age of 50 years. RESULTS 445 patients were included (42.9% laparoscopic and 57.1% open). Overall rate of PUR was 11.2% (12% laparoscopic, 10.6% open, and p = 0.64). In univariate analysis, PUR was significantly associated with patient age >50 and history of benign prostatic hyperplasia (BPH). Risk stratification for age >50 revealed in this cohort a 2.49 times increased PUR risk with lack of intraoperative bladder decompression (p = 0.013). CONCLUSIONS At our institution, we found that patient age, history of BPH, and bilateral repair were associated with PUR after inguinal hernia repair. No association was found with PUR and laparoscopic vs open approach. Older males may be at higher risk without intraoperative bladder decompression, and therefore, catheter placement should be considered in this population, regardless of surgical approach.
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Affiliation(s)
- A B Blair
- Department of Surgery, Johns Hopkins Medical Institution, Baltimore, MD, USA
| | - A Dwarakanath
- School of Medicine, Johns Hopkins, Baltimore, MD, USA
| | - A Mehta
- School of Medicine, Johns Hopkins, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - H Liang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - X Hui
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Wyman
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - J P P Ouanes
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - H T Nguyen
- Department of Surgery, Johns Hopkins Medical Institution, Baltimore, MD, USA. .,Comprehensive Hernia Center, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD, USA.
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Guo W, Hui X, Alfaifi S, Robertson S, Anderson L, Hales R, Hu C, McNutt T, Broderick S, Voong R. Is Radiation Fall-off Dose to the Uninvolved Lung Important? The Impact of Pre-Operative Contralateral Lung Radiation Dose on Post-Operative Pulmonary Toxicity. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.01.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Quon H, Hui X, Cheng Z, Robertson S, Bowers M, Moore J, Choflet A, Burns L, Page B, Kiess A, Maclean J, Wu P, Omari T, Szczesniak M, Gourin C, Cook I, McNutt T. Quantitative Evaluation of Radiation-Induced Dysphagia Using Patient-Reported Outcome Instruments in the Development of a Personalized Head and Neck Cancer Treatment Deintensification Paradigm. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hernandez A, Cheng Z, Hui X, Kiess A, Robertson S, Moore J, Bowers M, Choflet A, Wong J, McNutt T, Quon H, Burns L, Thompson A. The Role of Ensemble Machine Learning Algorithms to Predict Weight Loss Following Head and Neck Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Cheng Z, Hui X, Robertson S, Yang W, Peng L, Choflet A, Burns L, Thompson A, Muse M, Bowers M, Moore J, Page B, Kiess A, McNutt T, Quon H. Predictive Factors for Reactive/Therapeutic Feeding Tube Use in the Irradiated Head and Neck Cancer (HNC) Patient. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jung EC, Zhu H, Zou Y, Elmahdy A, Cao Y, Hui X, Maibach HI. Effect of ultrasound and heat on percutaneous absorption of l-ascorbic acid: human in vitro studies on Franz cell and Petri dish systems. Int J Cosmet Sci 2016; 38:646-650. [PMID: 27380114 DOI: 10.1111/ics.12350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/02/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Percutaneous absorption of l-ascorbic acid (LAA) is limited due to its high hydrophilicity and low stability. Here, we investigated the effect of post-dosing sonophoresis (329 kHz, 20 mW cm-2 ) and heat (36°C) on transdermal delivery of LAA. METHODS Ultrasound/heat, heat and control treatments were applied on skin surface for 2 and 5 min after topical application of C14-labelled LAA aqueous solution. After 15 min post-exposure, radioactivity was measured in tape-striped stratum corneum (TS-SC), epidermis, dermis and receptor fluid. As Franz diffusion cell model may have different acoustic response than in vivo human tissues, a novel Petri dish model was developed and compared with Franz cell model on the effects of ultrasound/heat treatment on the skin permeability. RESULTS Five-min ultrasound/heat treatment significantly accelerated skin absorption/penetration of LAA; 2-min treatment showed no enhancement effect on Franz diffusion cell model at the end of experiment. The use of Petri dish model significantly increased LAA concentrations in epidermis after 5 min of ultrasound/heat treatment, compared to the results of Franz cell model. CONCLUSION Combination of ultrasound (329 kHz, 20 mW cm-2 ) and heat (36°C) significantly enhanced LAA transdermal penetration, when the time of treatment was sufficient (5 min). As Petri dish model was designed to simulate acoustic respond of dense human tissue to ultrasound, the difference between Franz cell and Petri dish models suggests that the enhancement effect of ultrasound/heat on skin penetration in vivo may be greater than that determined on in vitro Franz cell model.
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Affiliation(s)
- E C Jung
- Department of Dermatology, University of California San Francisco, 90 Medical Center Way, Surge 110, San Francisco, CA, USA
| | - H Zhu
- Department of Dermatology, University of California San Francisco, 90 Medical Center Way, Surge 110, San Francisco, CA, USA
| | - Y Zou
- Skin & Cosmetic Research Department, Shanghai Skin Disease Hospital, Shanghai, China
| | - A Elmahdy
- Department of Dermatology, University of California San Francisco, 90 Medical Center Way, Surge 110, San Francisco, CA, USA
| | - Y Cao
- Department of Dermatology, University of California San Francisco, 90 Medical Center Way, Surge 110, San Francisco, CA, USA
| | - X Hui
- Department of Dermatology, University of California San Francisco, 90 Medical Center Way, Surge 110, San Francisco, CA, USA
| | - H I Maibach
- Department of Dermatology, University of California San Francisco, 90 Medical Center Way, Surge 110, San Francisco, CA, USA
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Robertson SP, Moore JA, Hui X, DeWeese TL, Tran P, Quon H, Cheng Z, Bzdusek K, Kumar P, McNutt TR. SU-D-BRB-02: Combining a Commercial Autoplanning Engine with Database Dose Predictions to Further Improve Plan Quality. Med Phys 2016. [DOI: 10.1118/1.4955628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dietz RM, Deng G, Orfila JE, Hui X, Traystman RJ, Herson PS. Therapeutic hypothermia protects against ischemia-induced impairment of synaptic plasticity following juvenile cardiac arrest in sex-dependent manner. Neuroscience 2016; 325:132-41. [PMID: 27033251 DOI: 10.1016/j.neuroscience.2016.03.052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/18/2016] [Accepted: 03/22/2016] [Indexed: 10/22/2022]
Abstract
Pediatric cardiac arrest (CA) often leads to poor neurologic outcomes, including deficits in learning and memory. The only approved treatment for CA is therapeutic hypothermia, although its utility in the pediatric population remains unclear. This study analyzed the effect of mild therapeutic hypothermia after CA in juvenile mice on hippocampal neuronal injury and the cellular model of learning and memory, termed long-term potentiation (LTP). Juvenile mice were subjected to cardiac arrest and cardiopulmonary resuscitation (CA/CPR) followed by normothermia (37°C) and hypothermia (30°C, 32°C). Histological injury of hippocampal CA1 neurons was performed 3days after resuscitation using hematoxylin and eosin (H&E) staining. Field excitatory post-synaptic potentials (fEPSPs) were recorded from acute hippocampal slices 7days after CA/CPR to determine LTP. Synaptic function was impaired 7days after CA/CPR. Mice exposed to hypothermia showed equivalent neuroprotection, but exhibited sexually dimorphic protection against ischemia-induced impairment of LTP. Hypothermia (32°C) protects synaptic plasticity more effectively in females, with males requiring a deeper level of hypothermia (30°C) for equivalent protection. In conclusion, male and female juvenile mice exhibit equivalent neuronal injury following CA/CPR and hypothermia protects both males and females. We made the surprising finding that juvenile mice have a sexually dimorphic response to mild therapeutic hypothermia protection of synaptic function, where males may need a deeper level of hypothermia for equivalent synaptic protection.
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Affiliation(s)
- R M Dietz
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Neuronal Injury Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - G Deng
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Neuronal Injury Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - J E Orfila
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Neuronal Injury Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - X Hui
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Neuronal Injury Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - R J Traystman
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO, USA; Neuronal Injury Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - P S Herson
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pharmacology, University of Colorado School of Medicine, Aurora, CO, USA; Neuronal Injury Program, University of Colorado School of Medicine, Aurora, CO, USA.
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Ren BX, Zong J, Tang JC, Sun DP, Hui X, Li RQ, Zhang JL, Ji Y. Effects of intravenous analgesia with combined dezocine and butorphanol on postoperative cognitive function in elderly patients. Genet Mol Res 2015; 14:5571-6. [PMID: 26125754 DOI: 10.4238/2015.may.25.8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of this study was to observe the analgesic effects of the combination of dezocine and butorphanol on postoperative cognitive function in elderly patients. Forty elderly patients undergoing upper abdominal surgeries or thoracotomies with general anesthesia were randomly divided into the dezocine and butorphanol group or the butorphanol group (20 patients per group). A visual analog scale was used to evaluate analgesia and the degree of malignant vomiting. The Ramsay scoring method was used to evaluate sedation. The Mini-Mental State Examination (MMSE) was used to evaluate cognitive function. Forty-eight hours after the operation, the pain score of the dezocine and butorphanol group (means ± SD, 1.75 ± 0.44) was lower than that of the butorphanol group (2.25 ± 0.79; P < 0.05), and the nausea and vomiting score of the dezocine and butorphanol group (0) was lower than that of the butorphanol group (0.70 ± 1.30; P < 0.05). Six hours after the operation, the sedative score of the butorphanol group (3.75 ± 0.79) was higher than that of the dezocine and butorphanol group (2.15 ± 0.75; P < 0.05). Compared to 1 day before the operation, the MMSE scores of both groups decreased 6 h after the operation, and the MMSE score of the butorphanol group (15.00 ± 2.00) was lower than that of the dezocine and butorphanol group (20.95 ± 1.54; P < 0.05). Dezocine and butorphanol analgesia had transient effects on postoperative cognitive function in elderly patients, and the effect of the combination was superior than butorphanol only.
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Affiliation(s)
- B X Ren
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - J Zong
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - J C Tang
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - D P Sun
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - X Hui
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - R Q Li
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - J L Zhang
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Y Ji
- Department of Anesthesiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
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Abstract
INTRODUCTION Onychomycosis, a common fungal infection in the finger and toe nails, affects approximately 2-8% of the worldwide population. Fungal infection is more complicated in those who suffer from conditions, such as diabetes, peripheral vascular diseases and compromised immune diseases. AREA COVERED Onychomycosis treatment has been classified on the basis of location of infection in the toes and fingers and infectious agents (dermatophytes fungi, yeast and non-dermatophyte molds). In this review, the available therapies (traditional and device based) and their limitations for the treatment of onychomycosis have been discussed. EXPERT OPINION The success rate with topical nail products has been minimal. The main reason for this poor success rate could be attributed to the lack of complete understanding of the pathophysiology of the disease and clinical pharmacokinetic data of drugs in the infected nail apparatus.
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Affiliation(s)
- Avadhesh Kushwaha
- a Institute for Drug Delivery and Biomedical Research , Bangalore , India .,b Department of Pharmaceutics , University of Mississippi, University , MS , USA , and
| | - Reena N Murthy
- a Institute for Drug Delivery and Biomedical Research , Bangalore , India
| | - S Narasimha Murthy
- a Institute for Drug Delivery and Biomedical Research , Bangalore , India .,b Department of Pharmaceutics , University of Mississippi, University , MS , USA , and
| | - Rania Elkeeb
- c Department of Dermatology , University of California , San Francisco , CA , USA
| | - X Hui
- c Department of Dermatology , University of California , San Francisco , CA , USA
| | - Howard I Maibach
- c Department of Dermatology , University of California , San Francisco , CA , USA
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Ren BX, Ji Y, Tang JC, Sun DP, Hui X, Yang DQ, Zhu XL. Effect of Tanshinone IIA intrathecal injections on pain and spinal inflammation in mice with bone tumors. Genet Mol Res 2015; 14:2133-8. [PMID: 25867360 DOI: 10.4238/2015.march.20.24] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The study aimed to investigate the effect of intrathecal injections of Tanshinone IIA on thermal hyperalgesia in a mouse model of bone cancer-pain. Spinal IL-1β, IL-6, TNF-α expression levels were analyzed. C3H/HeNCrlVr male mice were assigned to groups that either received dose-dependent injections of Tanshinone IIA, or the DMSO + Sham, Tanshinone IIA + Sham, DMSO + Tumor, and Control groups. Paw withdrawal thermal latency (PWTL) was measured with a radiant heat stimulus and mRNA expression levels were determined using real-time PCR. Fourteen days post-injection, PWTL in the DMSO + Tumor group was lower than that in the controls (P < 0.05). Twenty-one days post-injection, compared with the Control group, there was no significant difference in PWTL and IL-1β, IL-6, and TNF-α expression levels between the Tanshinone IIA + Sham and DMSO + Sham groups (P > 0.05). PWTL in the DMSO + Tumor group was significantly lower than the Control group (P < 0.05), while the expression levels of IL-1β, IL-6, and TNF-α were significantly higher than controls. Compared with the DMSO + Tumor group, PWTLs were higher in the Tanshinone IIA - 20-μg and 40-μg groups, while expression levels of IL-1β, IL-6, and TNF-α were significantly lower (P < 0.05). These measures were not significantly different between the Tanshinone IIA 10 μg and the DMSO + Tumor groups (P > 0.05). In conclusion, Tanshinone IIA may inhibit the release of inflammatory cytokines, such as, IL-1 β, IL-6 α, TNF-α.
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Affiliation(s)
- B X Ren
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
| | - Y Ji
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
| | - J C Tang
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
| | - D P Sun
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
| | - X Hui
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
| | - D Q Yang
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
| | - X L Zhu
- Anesthesiology Affiliated Hospital, University Jiangnan, Wuxi, Jiangsu Province, China
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Li H, Hui X, Li K, Tang X, Hu X, Xu A, Wu D. High-level expression, purification and characterization of active human C1q and tumour necrosis factor-related protein-1 in Escherichia coli. Lett Appl Microbiol 2014; 59:334-41. [PMID: 24814641 DOI: 10.1111/lam.12280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 05/05/2014] [Accepted: 05/05/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED C1q and tumour necrosis factor-related proteins (CTRPs) are a family of adiponectin paralogues. CTRP1 plays important biological functions in diabetes, obesity and hypertension. To further explore the physiological roles of human CTRP1 and its mechanisms of action, hCTRP1 gene was expressed in Escherichia coli. In the E. coli expression system, a large amount of soluble thioredoxin (Trx)-hCTRP1 fusion protein could be produced using the expression plasmid pET32a (+) and induction with IPTG at 18°C, which accounts about 20% of the total soluble bacterial proteins. The recombinant Trx-hCTRP1 fusion protein was purified to an approx. 95% purity using Ni-NTA affinity chromatography and Superdex G-75 column with a yield of about 28-mg protein from 1-l bacterial cultures. The purified recombinant Trx-hCTRP1 was shown to be active under in vivo and in vitro assay conditions. SIGNIFICANCE AND IMPACT OF THE STUDY CTRP1 plays important biological functions and warrants further investigation. However, large-scale production of recombinant CTRP1 has been technically challenging, which becomes a major obstacle in the structural and functional analysis of this important family of proteins. To explore the possible clinical applications and mechanisms of its action, an efficient method to produce large amounts of active recombinant human CTRP1 is necessary. This study should facilitate basic functional and pharmacological studies of this important protein family.
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Affiliation(s)
- H Li
- Department of Life Sciences, The Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Huaihua College, Huaihua, China; The Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
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Hui X, Schneider E, Ali M, Schwartz D, Canner J, Leeper W, Efron D, Haut E, Velopulos C, Pawlik T, Haider A. Worse Outcomes Among Uninsured General Surgery Patients: Does the Need for an Emergency Operation Explain These Disparities? J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Canner J, Haider A, Hui X, Selvarajah S, Wang H, Efron D, Haut E, Velopulos C, Schwartz D, Chi A, Schneider E. U.S. Emergency Department Visits for Injuries Due to Fireworks, 2006-2010: Have Skyrocketing Sales Led to an Explosion of Injuries? J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lwin A, Velopulos C, Hui X, Cerullo M, Ali M, Schneider E, Kironji A, Britton B, Haut E, Efron D, Haider A. Economics of an Emergency Room Visit After a Minor Injury: The Cost of Not Being Insured. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sun J, Ying W, Liu D, Hui X, Yu Y, Wang J, Wang X. Clinical and genetic features of 5 Chinese patients with X-linked lymphoproliferative syndrome. Scand J Immunol 2014; 78:463-7. [PMID: 23944711 DOI: 10.1111/sji.12103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 08/04/2013] [Indexed: 11/28/2022]
Abstract
In this study, we report the clinical and genetic features of Chinese patients with X-linked lymphoproliferative syndrome (XLP). Male patients with fulminant infectious mononucleosis (FIM), Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH) or persistent EBV viremia were enrolled in this study. Direct sequencing was used to detect SH2D1A/XIAP gene mutations. The patients' clinical features were assessed by retrieval of data from medical records. Twenty-one male patients with FIM, EBV-associated HLH or persistent EBV viremia were evaluated. Four patients had SH2D1A mutations, and one patient had an XIAP mutation. All five of these patients had symptoms of HLH and EBV infection. Among the five patients, the youngest one was only 1 month old at onset. One patient exhibited hypogammaglobulinemia. Of four patients evaluated for immunological function, all exhibited reduced CD4/CD8 ratios. Three patients had rapid disease progression and died. One patient received haematopoietic stem cell transplantation and is well. The overall clinical phenotypes of Chinese patients with XLP matched previous reports. For patients with severe EBV-associated HLH, our results indicate the need to examine the possibility of XLP.
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Affiliation(s)
- J Sun
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai, China
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Pal A, Hashmi Z, Zafar S, Hui X, Scott V, Efron D, Haut E, Schneider E, Haider A. Burden of Comorbidities in Geriatric Trauma: Should the Elderly Continue to be Excluded From Risk-Adjusted Trauma Mortality Analyses? J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Liu XJ, Xu Y, Hui X, Lu ZP, Li F, Chen GL, Lu J, Liu CT. Metallic liquids and glasses: atomic order and global packing. Phys Rev Lett 2010; 105:155501. [PMID: 21230918 DOI: 10.1103/physrevlett.105.155501] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 07/16/2010] [Indexed: 05/30/2023]
Abstract
In this Letter, we have revealed the common structural behavior of metallic glasses through scrutinizing the evolution of pair distribution functions from metallic liquids to glasses and statistically analyzing pair distribution functions of 64 metallic glasses. It is found that the complex atomic configuration in metallic glasses can be interpreted globally as a combination of the spherical-periodic order and local translational symmetry. The implications of our study suggest that the glass transition could be visualized mainly as a process involving in local translational symmetry increased from the liquid to glassy states.
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Affiliation(s)
- X J Liu
- State Key Laboratory for Advanced Metals and Materials, University of Science and Technology Beijing, Beijing 100083, China
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Sun SF, Pan QZ, Hui X, Zhang BL, Wu HM, Li H, Xu W, Zhang Q, Li JY, Deng XM, Chen JW, Lian ZX, Li N. Stronger in vitro phagocytosis by monocytes-macrophages is indicative of greater pathogen clearance and antibody levels in vivo. Poult Sci 2008; 87:1725-33. [PMID: 18753439 DOI: 10.3382/ps.2007-00202] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Monocytes-macrophages are crucial players in specific and nonspecific immune responses to protect organisms from invasion of bacteria or viruses. In this study, monocytes in circulation from 2 lines of Silky and Starbro chickens with different disease resistance were separated and cultured in vitro. After identification with acridine orange (AO), Giemsa staining, and CD14 immunostaining, monocytes-macrophages were used for adherence and phagocytosis test. The overall percentages of adherence of Silky monocytes was 1.5 times greater than that of Starbro (P < 0.01), which were 26.85% +/- 8.24% and 18.34% +/- 8.15%, respectively (mean +/- SD). The monocytes-macrophages phagocytic index, phagocytic product, and percentage of phagocytosis in Silkies were greater than in Star-bros, respectively. The difference of phagocytic index was significant (P < 0.05), that is, 3.70 +/- 1.75 and 1.97 +/- 0.31, respectively (mean +/- SD). Then, 20 Silkies were divided into 2 groups according to phagocytic index: high phagocytic index (HPI) group and low phagocytic index (LPI) group, to study the relationship between phagocytic activity in vitro and pathogen clearance. After being challenged against Salmonella Pullorum C79-13, the Silky birds with HPI produced a 3-fold greater level of specific antibodies compared with those with LPI (P < 0.01), 50.21 +/- 6.67 and 16.85 +/- 4.52, respectively (mean +/- SD). In contrast to LPI birds, HPI birds shed less Salmonella Pullorum bacteria (P < 0.05), that is, 168.98 x 10(8) +/- 294.74 x 10(8) compared to 385.40 x 10(8) +/- 399.94 x 10(8) (mean +/- SD), and the shedding peak of Salmonella Pullorum in the test span appeared 4 d earlier. These results indicated that phagocytosis of monocytes-macrophages had strong effects on antibody titer and bacteria shedding postchallenge, which could be used to predict the disease resistance in animals.
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Affiliation(s)
- S F Sun
- National Key Laboratory of Agricultural Biotechnology, Beijing, China
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Zhao L, Li T, Wang Y, Pan Y, Ning H, Hui X, Xie H, Wang J, Han Y, Liu Z, Fan D. Elevated plasma osteopontin level is predictive of cirrhosis in patients with hepatitis B infection. Int J Clin Pract 2008; 62:1056-62. [PMID: 17537188 DOI: 10.1111/j.1742-1241.2007.01368.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Osteopontin (OPN) was shown to play an important role in the pathogenesis of various inflammatory and fibrotic processes and elevated in fibrotic liver of mouse model. However, the significance of OPN in hepatitis B virus (HBV)-induced liver cirrhosis (LC) remains unclear and is therefore evaluated in this study. METHODS Thirty-nine patients with HBV-induced LC, 30 patients with HBV infection but without cirrhosis, 11 patients with HBV-related hepatocellular carcinoma (HCC) and 14 additional healthy controls were enrolled in this study. Plasma levels of OPN were measured with enzyme-linked immunosorbent assay and the relationship between OPN and clinical parameters was evaluated. RESULTS When compared to HBV infection group (median 2.16 ng/ml), plasma levels of OPN were significantly increased in cirrhosis (4.52 ng/ml, p < 0.001) and cancer group (13.38 ng/ml, p < 0.001). The OPN level was correlated with the severity of liver damage according to Child-Pugh classification (p = 0.003). It showed at least comparable sensitivity and specificity to predict cirrhosis as aspartate aminotransferase to platelet ratio index, a previously established non-invasive serum marker of cirrhosis. CONCLUSIONS These data suggest that OPN could be used to evaluate the existence of LC, as OPN has previously been reported to be increased in the HCC; this unique feature makes OPN a promising candidate for prediction biomarker in the long-time surveillance of patients with HBV infection to evaluate the risk of cirrhosis and cancer.
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Affiliation(s)
- L Zhao
- State Key Laboratory of Cancer Biology & Institute of Gastroenterology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Beijing, China.
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Zhai H, Chan HP, Hui X, Maibach HI. Skin decontamination of glyphosate from human skin in vitro. Food Chem Toxicol 2008; 46:2258-60. [PMID: 18407393 DOI: 10.1016/j.fct.2008.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 02/09/2008] [Accepted: 03/03/2008] [Indexed: 11/28/2022]
Abstract
This study compared three model decontaminant solutions (tap water, isotonic saline, and hypertonic saline) for their ability to remove a model herbicide (glyphosate) from an in vitro human skin model. Human cadaver skin was dosed (approximately 375microg) of [14C]-glyphosate on 3cm2 per skin. After each exposure time (1, 3, and 30min post-dosing, respectively), the surface skin was washed three times (4ml per time) with each solution. After washing, the skin was stripped twice with tape discs. Lastly, the wash solutions, strippings, receptor fluid, and remainder of skin were liquid scintillation analyzer counted to determine the amount of glyphosate. There were no statistical differences among these groups at any time points. The total mass balance recovery at three time exposure points was between 94.8% and 102.4%. The wash off rates (glyphosate in wash solutions) at three different exposure times is 79-101.2%. Thus the three tested decontaminants possess similar effectiveness in removing glyphosate from skin. This in vitro model is not only economic and rapid, but also provides quantitative data that may aid screening for optimal decontaminants.
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Affiliation(s)
- H Zhai
- Department of Dermatology, University of California, School of Medicine, Box 0989, Surge 110, 90 Medical Center Way, San Francisco, CA 94143-0989, USA.
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Abstract
Nitrogen fixation (nif) genes of diazotrophic enteric bacteria,Enterobacter cloacae orKlebsiella pneumoniae, are regulated bynif LA operon, in which thenif A product, NifA positively regulatesnif gene transcription, whereas the nifL product NifL represses it under oxygen or in excess of fixed nitrogen. Two-hybrid system was used to detect the possible interaction between NifA and NifL. The preliminary results illustrate that NifL does interact with NifA. The interaction between NifL and NtrC has also been shown.
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Affiliation(s)
- X Hui
- Laboratory of Molecular Genetics, Shanghai Institute of Plant Physiology, Chinese Academy of Sciences, 200032, Shanghai, China
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Zhai H, Barbadillo S, Hui X, Maibach HI. In vitro model for decontamination of human skin: Formaldehyde. Food Chem Toxicol 2007; 45:618-21. [PMID: 17123683 DOI: 10.1016/j.fct.2006.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2006] [Revised: 10/10/2006] [Accepted: 10/17/2006] [Indexed: 10/24/2022]
Abstract
Decontamination of a chemical from skin is often an emergency measure. This study utilized an in vitro model to compare the decontamination capacity of three model decontaminant solutions (tap water, isotonic saline, and hypertonic saline). Human cadaver skin was dosed (approximately 0.25 microg on 3 cm(2) per skin) with radio-labeled [(14)C]-formaldehyde. After a defined exposure time (1, 3, and 30 min post-dosing, respectively), the surface skin was washed three times (4ml per time) with each solution. After washing, the skin was stripped with tape discs twice. Lastly, the wash solutions, strippings, receptor fluid, and remainder of skin were liquid scintillation analyzer counted to determine the amounts of formaldehyde. Additionally, an evaporation test at different exposure times (1min, 3min, 15min, 30min, and 60min, respectively) was conducted to monitor formaldehyde % evaporation. There were no statistical differences among these groups except isotonic saline, at 3min post-exposure (in wash solutions), showed a significantly difference (p<0.05) when compared to tap water. Formaldehyde % evaporation increased linearly with extending application times, and were 7.7%, 13.6%, 19.7%, 24.4%, and 35.9% (1min, 3min, 15min, 30min, and 60min, respectively). This data suggests that isotonic saline may be effective in removing formaldehyde from skin. However, results from this model need validation in vivo. The model may provide a facile and robust method of accelerating knowledge of decontamination mechanism and lead to enhanced efficacy.
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Affiliation(s)
- H Zhai
- Department of Dermatology, University of California, School of Medicine, Box 0989, Surge 110, 90 Medical Center Way, San Francisco, CA 94143-0989, USA.
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Qureshi F, Cetin S, Drain P, Murray S, Hui X, Li J, Boyle P, Ford H, Hackam D. Interferon gamma inhibits inter-enterocyte communication by reducing connexin 43 phosphorylation. J Surg Res 2004. [DOI: 10.1016/j.jss.2004.07.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hui X, Anigbogu A, Singh P, Xiong G, Poblete N, Liu P, Maibach HI. Pharmacokinetic and local tissue disposition of [14C]sodium diclofenac following iontophoresis and systemic administration in rabbits. J Pharm Sci 2001; 90:1269-76. [PMID: 11745779 DOI: 10.1002/jps.1079] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The systemic pharmacokinetics and local drug distribution of sodium diclofenac in skin and underlying tissues was studied. Iontophoresis facilitated local and systemic delivery of diclofenac sodium compared with passive diffusion. The maximum plasma concentration of sodium diclofenac was achieved within 1 h of iontophoresis, and the delivery was proportional to applied current density (371 +/- 141 and 132 +/- 62 microg/L at 0.5 and 0.2 mA/cm(2), respectively). The in vivo delivery efficiency for diclofenac in rabbit was 0.15 mg/mA.h. The concentrations of sodium diclofenac in the skin, subcutaneous tissue, and muscle beneath the drug application site (cathode) were significantly greater than plasma concentrations and concentrations of drug in similar tissues at the untreated sites. The results thus suggest that the cutaneous microvasculature is not always a perfect "sink" and that transdermal iontophoresis facilitated the direct penetration of diclofenac sodium to deeper tissues. No skin irritation was observed up to 0.5 mA/cm(2) current density and 7 mg/mL sodium diclofenac concentration.
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Affiliation(s)
- X Hui
- Department of Dermatology, University of California San Francisco, Surge 110, Box 0989, San Francisco, CA 94143-0989, USA.
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Abstract
Carbon tetrachloride (CCl4) has been found to induce cellular damage by generating oxygen free radicals. A study was carried out to investigate the effects of taurine (extracted from Pegasus laternarius Cuvier) on CCl4 intoxicated cultured neurons. CCl4 application (0.4 mmol x l(-1), 0.8 mmol x l( -1), 1.2 mmol x l (-1) and 1.6 mmol x l(-1 )) increased the lipid peroxidation product and decreased glutathione peroxidase (GPx) activity significantly in a concentration dependent manner. Pretreatment of cultures with taurine (10 micromol x l(-1), 30 micromol x l(-1) and 60 micromol x l(-1)) prevented the loss of GPx activity and lipid peroxidation. The effects of three different dosages of taurine (10 mg/kg body wt., 20 mg/kg body wt. and 40 mg/ kg body wt.) for 45 days on the activities of superoxide dismutase and glutathione peroxidase were examined in the cerebrum, cerebellum and medulla of normal and CCl4 treated mice. Treatment of mice with taurine provided protection against CCl4 toxicity as was evident by lipid peroxide status. Taurine was not so successful at inducing the activity of SOD in normal animals except in the medulla where it could increase the activity of SOD (p < 0.05). Taurine induces the GPx activity in a dose dependent manner in all regions of the brain studied. Also in the CCl4 poisoned mice taurine could augment the status of GPx activity in a dose dependent manner. Hence it is concluded that taurine can protects neurons from the oxidative stress induced by CCl4.
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Affiliation(s)
- B P Vohra
- Department of Biotechnology, School of Life sciences, Sun-Yat-Sun University, Guangzhou, China.
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Poet TS, Corley RA, Thrall KD, Edwards JA, Tanojo H, Weitz KK, Hui X, Maibach HI, Wester RC. Assessment of the percutaneous absorption of trichloroethylene in rats and humans using MS/MS real-time breath analysis and physiologically based pharmacokinetic modeling. Toxicol Sci 2000; 56:61-72. [PMID: 10869454 DOI: 10.1093/toxsci/56.1.61] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The development and validation of noninvasive techniques for estimating the dermal bioavailability of solvents in contaminated soil and water can facilitate the overall understanding of human health risk. To assess the dermal bioavailability of trichloroethylene (TCE), exhaled breath was monitored in real time using an ion trap mass spectrometer (MS/MS) to track the uptake and elimination of TCE from dermal exposures in rats and humans. A physiologically based pharmacokinetic (PBPK) model was used to estimate total bioavailability. Male F344 rats were exposed to TCE in water or soil under occluded or nonoccluded conditions by applying a patch to a clipper-shaved area of the back. Rats were placed in off-gassing chambers and chamber air TCE concentration was quantified for 3-5 h postdosing using the MS/MS. Human volunteers were exposed either by whole-hand immersion or by attaching patches containing TCE in soil or water on each forearm. Volunteers were provided breathing air via a face mask to eliminate inhalation exposure, and exhaled breath was analyzed using the MS/MS. The total TCE absorbed and the dermal permeability coefficient (K(P)) were estimated for each individual by optimization of the PBPK model to the exhaled breath data and the changing media and/or dermal patch concentrations. Rat skin was significantly more permeable than human skin. Estimates for K(P) in a water matrix were 0.31 +/- 0.01 cm/h and 0.015 +/- 0.003 cm/h in rats and humans, respectively. K(P) estimates were more than three times higher from water than soil matrices in both species. K(P) values calculated using the standard Fick's Law equation were strongly affected by exposure length and volatilization of TCE. In comparison, K(P) values estimated using noninvasive real-time breath analysis coupled with the PBPK model were consistent, regardless of volatilization, exposure concentration, or duration.
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Affiliation(s)
- T S Poet
- Chemical Dosimetry, Battelle, Pacific Northwest Division, Post Office Box 999, MSIN P7-59, Richland, Washington 99352, USA.
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Thrall KD, Poet TS, Corley RA, Tanojo H, Edwards JA, Weitz KK, Hui X, Maibach HI, Wester RC. A real-time in-vivo method for studying the percutaneous absorption of volatile chemicals. Int J Occup Environ Health 2000; 6:96-103. [PMID: 10828137 DOI: 10.1179/oeh.2000.6.2.96] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Realistic estimates of percutaneous absorption following exposures to solvents in the workplace, or through contaminated soil and water, are critical to understanding human health risks. A method was developed to determine dermal uptake of solvents under non-steady-state conditions using real-time breath analysis in rats, monkeys, and humans. The exhaled breath was analyzed using an ion-trap mass spectrometer, which can quantitate chemicals in the exhaled breath stream in the 1-5 ppb range. The resulting data were evaluated using physiologically-based pharmacokinetic (PBPK) models to estimate dermal permeability constants (Kp) under various exposure conditions. The effects of exposure matrix (soil versus water), occlusion versus non-occlusion, and species differences on the absorption of methyl chloroform, trichloroethylene, and benzene were compared. Exposure concentrations were analyzed before and at 0.5-hour intervals throughout the exposures. The percentage of each chemical absorbed and the corresponding Kp were estimated by optimization of the PBPK model to the medium concentration and the exhaled-breath data. The method was found to be sufficiently sensitive for animal and human dermal studies at low exposure concentrations over small body surface areas, for short periods, using non-steady-state exposure conditions.
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Affiliation(s)
- K D Thrall
- Molecular Biosciences Department, Pacific Northwest National Laboratory, P.O. Box 999, Mail Stop P7-59, Richland, WA 99352, USA.
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Poet TS, Thrall KD, Corley RA, Hui X, Edwards JA, Weitz KK, Maibach HI, Wester RC. Utility of real time breath analysis and physiologically based pharmacokinetic modeling to determine the percutaneous absorption of methyl chloroform in rats and humans. Toxicol Sci 2000; 54:42-51. [PMID: 10746930 DOI: 10.1093/toxsci/54.1.42] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Due to the large surface area of the skin, percutaneous absorption has the potential to contribute significantly to the total bioavailability of some compounds. Breath elimination data, acquired in real-time using a novel MS/MS system, was assessed using a PBPK model with a dermal compartment to determine the percutaneous absorption of methyl chloroform (MC) in rats and humans from exposures to MC in non-occluded soil or occluded water matrices. Rats were exposed to MC using a dermal exposure cell attached to a clipper-shaved area on their back. The soil exposure cell was covered with a charcoal patch to capture volatilized MC and prevent contamination of exhaled breath. This technique allowed the determination of MC dermal absorption kinetics under realistic, non-occluded conditions. Human exposures were conducted by immersing one hand in 0.1% MC in water, or 0.75% MC in soil. The dermal PBPK model was used to estimate skin permeability (Kp) based on the fit of the exhaled breath data. Rat skin K(p)s were estimated to be 0.25 and 0.15 cm/h for MC in water and soil matrices, respectively. In comparison, human permeability coefficients for water matrix exposures were 40-fold lower at 0.006 cm/h. Due to evaporation and differences in apparent Kp, nearly twice as much MC was absorbed from the occluded water (61.3%) compared to the non-occluded soil (32.5%) system in the rat. The PBPK model was used to simulate dermal exposures to MC-contaminated water and soil in children and adults using worst-case EPA default assumptions. The simulations indicate that neither children nor adults will absorb significant amounts of MC from non-occluded exposures, independent of the length of exposure. The results from these simulations reiterate the importance of conducting dermal exposures under realistic conditions.
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Affiliation(s)
- T S Poet
- Battelle, Pacific Northwest Division, Richland, Washington 99352, USA.
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47
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Abstract
Taurine was extracted from Pegasus laternarius Cuvier to study its effects on learning and memory in mice. Mice were treated with different doses of taurine (10 mg/kg, 20 mg/kg, 40 mg/kg). The mice were treated with various chemical agents (pentobarbital, cycloheximide, sodium nitrite, alcohol) to disrupt the normal memory process. We measured the effect of taurine on step-down latency (SDL) and escape latency (EL) in a passive avoidance task after 10 or 30 days. Treatment with taurine alone did not change either SDL or EL. Taurine protected mice from the memory disruption induced by alcohol, pentobarbital, sodium nitrite, and cycloheximide but had no obvious effect on motor coordination, exploratory activity, or locomotor activity as measured using the rota-rod test and the hole board test. We conclude that taurine can be effective in attenuating the amnesia produced by alcohol, pentobarbital, cycloheximide, and sodium nitrite without compromising the behavioral aspects of the animals tested.
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Affiliation(s)
- B P Vohra
- Department of Biotechnology, School of Life Sciences, Sun-Yat-Sen University, Guangzhou, China-510 275.
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48
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Buchholz BA, Fultz E, Haack KW, Vogel JS, Gilman SD, Gee SJ, Hammock BD, Hui X, Wester RC, Maibach HI. HPLC-accelerator MS measurement of atrazine metabolites in human urine after dermal exposure. Anal Chem 1999; 71:3519-25. [PMID: 10464479 DOI: 10.1021/ac990152g] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Metabolites of atrazine were measured in human urine after dermal exposure using HPLC to separate and identify metabolites and accelerator mass spectrometry (AMS) to quantify them. Ring-labeled [14C]atrazine was applied for 24 h with a dermal patch to human volunteers at low (0.167 mg, 6.45 muCi) and high (1.98 mg, 24.7 muCi) doses. Urine was collected for 7 days. The urine was centrifuged to remove solids, and the supernatant was measured by liquid scintillation counting prior to injection on the HPLC to ensure that < 0.17 Bq (4.5 pCi) was injected on the column. A reversed-phase gradient of 0.1% acetic acid in water and 0.1% acetic acid in acetonitrile became less polar with increasing time and separated the parent compound and major atrazine metabolites over 31 min on an octadecylsilane column. Peaks were identified by coelution with known standards. Elution fractions were collected in 1-min increments; half of each fraction was analyzed by AMS to obtain limits of quantitation of 14 amol. Mercapturate metabolites of atrazine and dealkylated atrazine dominated the early metabolic time points, accounting for approximately 90% of the 14C in the urine. No parent compound was detected. The excreted atrazine metabolites became more polar with increasing time, and an unidentified polar metabolite that was present in all samples became as prevalent as any of the known ring metabolites several days after the dose was delivered. Knowledge of metabolite dynamics is crucial to developing useful assays for monitoring atrazine exposure in agricultural workers.
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Affiliation(s)
- B A Buchholz
- Center for Accelerator Mass Spectrometry, Lawrence Livermore National Laboratory, Livermore, California 94551, USA.
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49
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Wester RC, Hui X, Landry T, Maibach HI. In vivo skin decontamination of methylene bisphenyl isocyanate (MDI): soap and water ineffective compared to polypropylene glycol, polyglycol-based cleanser, and corn oil. Toxicol Sci 1999; 48:1-4. [PMID: 10330677 DOI: 10.1093/oxfordjournals.toxsci.a034663] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In the home and workplace, decontamination of a chemical from skin is traditionally done with a soap-and-water wash, although some workplaces may have emergency showers. It has been assumed that these procedures are effective, yet workplace illness and even death occur from chemical contamination. Water, or soap and water, may not be the most effective means of skin decontamination, particularly for fat-soluble materials. This study was undertaken to help determine whether there are more effective means of removing methylene bisphenyl isocyanate (MDI), a potent contact sensitizer, from the skin. MDI is an industrial chemical for which skin decontamination, using traditional soap and water and nontraditional polypropylene glycol, a polyglycol-based cleanser (PG-C), and corn oil were all tried in vivo on the rhesus monkey, over 8 h. Water, alone and with soap (5% and 50% soap), were partially effective in the first h after exposure, removing 51-69% of the applied dose. However, decontamination fell to 40-52% at 4 h and 29-46% by 8 h. Thus, the majority of MDI was not removed by the traditional soap-and-water wash; skin tape stripping after washing confirmed that MDI was still on the skin. In contrast, polypropylene glycol, PG-C, and corn oil all removed 68-86% of the MDI in the first h, 74-79% at 4 h, and 72-86% at 8 h. Statistically, polypropylene glycol, PG-C, and corn oil were all better (p < 0.05) than soap and water at 4 and 8 h after dose application. These results indicate that a traditional soap-and-water wash and the emergency water shower are relatively ineffective at removing MDI from the skin. More effective decontamination procedures, as shown here, are available. These procedures are consistent with the partial miscibility of MDI in corn oil and polyglycols.
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Affiliation(s)
- R C Wester
- Department of Dermatology, University of California, San Francisco 94143-0989, USA
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Hui X, Hewitt PG, Poblete N, Maibach HI, Shainhouse JZ, Wester RC. In vivo bioavailability and metabolism of topical diclofenac lotion in human volunteers. Pharm Res 1998; 15:1589-95. [PMID: 9794502 DOI: 10.1023/a:1011911302005] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The primary objective of this study was to determine the rate and extent of transdermal absorption for systemic delivery of diclofenac from Pennsaid (Dimethaid Research, Inc.) topical lotion into the systemic circulation after the lotion was applied to human volunteers, in an open treatment, non-blinded, non-vehicle controlled study. In addition, the in vivo metabolism of this topical diclofenac lotion has also been studied. METHODS Human volunteers were dosed with topical [14C]-diclofenac sodium 1.5% lotion on the knee for 24 h. Sequential time blood and urine samples were taken to determine pharmacokinetics, bioavailability and metabolism. RESULTS Topical absorption was 6.6% of applied dose. Peak plasma 14C occurred at 30 h after dosing, and peak urinary 14C excretion was at 24-48 h. The urinary 14C excretion pattern exhibits more elimination towards 24 h and beyond, as opposed to early urinary 14C excretion. This suggests a continuous delivery of [14C]-diclofenac sodium from the lotion into and through skin which only ceased when the dosing site was washed. Skin surface residue at 24 h was 26 +/- 9.5% dose (remainder assumed lost to clothing and bedding). Extraction of metabolites from urine amounted to 7.4-22.7% in untreated urine, suggesting substantial diclofenac metabolism to more water soluble metabolites, probably conjugates, which could not be extracted by the method employed. Two Dimensional TLC analysis of untreated urine showed minimal or no diclofenac, again emphasizing the extensive in vivo metabolism of this drug. Treatment of the same urine samples with the enzymes sulfatase and beta-glucuronidase showed a substantial increase in the extractable material. Three spots were consistently present in each sample run, namely diclofenac, 3'hydroxy diclofenac and an intermediate polar metabolite (probably a hydroxylated metabolite). Therefore, there was significant sulfation and glucuronidation of both diclofenac and numerous hydroxy metabolites of diclofenac, but many of the metabolites/conjugates remain unidentified. CONCLUSIONS; There was a continuous delivery of diclofenac sodium from the lotion into and through the skin, which ceased after the dosing site was washed. The majority of the material excreted in the urine were conjugates of hydroxylated metabolites, and not the parent chemical, although further identification is required.
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Affiliation(s)
- X Hui
- Department of Dermatology, University of California, San Francisco, 94143, USA
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